Non-missile penetrating spinal injury with an impaled knife

Abstract

Retention of all or part of the weapon following a non-missile penetrating spinal injury is a rare occurrence. The authors report a case of thoracic spinal cord stab injury in a young man. The patient presented with a knife blade lodged in his back and with Brown-Sequard-plus syndrome. At surgery, the wound with the knife in situ was explored and the knife was removed. Although the wound healed without evidence of cerebrospinal fluid leakage or infection, he developed a complete neurologic deficit post-operatively. This was an unlikely outcome for incomplete spinal cord injury resulting from non-missile penetrating spinal injury, historically known to have a favourable outcome. Pre-operatively, patients with incomplete neurological injury following penetrating spine injury with the retained foreign body should be specifically counselled on the possibility of a worsened neurological outcome after surgical intervention.

Keywords

• non-missile penetrating spinal injury (NMPSI)
• impaled knife
• Brown-Sequard-plus syndrome
• complete spinal cord injury